A combination of behavior-modification techniques and drug therapy manages AD/HD in children better than drug therapy alone - and can bring the same results with one-third the usual dosage. That's good news for parents who worry about the risks faced by kids who take high dosages of AD/HD medication.

These results come from a State University of New York at Buffalo study involving 27 kids with AD/HD. The children were treated with a skin patch containing methylphenidate, the main ingredient in Ritalin and other AD/HD drugs, and then treated with behavior-modification techniques, which seek to eliminate negative behaviors by explaining, demonstrating, and rewarding desirable behaviors. Two examples of the techniques:

Focusing on only a few problem areas at a time to keep a child from feeling overwhelmed by information.

Breaking large tasks into "subtasks" - for example, "clean your room" becomes "pick up clothes," "make the bed," and so on.

"Long-term side effects of AD/HD drugs are almost always related to dosage," says study leader William E. Pelham, Jr., Ph.D., professor of psychology at the university. "If you want to lower a child's dosages daily and throughout his lifetime, the best way to do that is to combine the medication with behavior modification."

Dr. Pelham's study appeared in the May 2005 issue of Experimental and Clinical Psychopharmacology.